The Omicron family of SARS-CoV-2 variants are currently driving the COVID-19 pandemic. Here we analyzed the clinical laboratory test results of 9911 Omicron BA.2.2 sublineages-infected symptomatic patients without earlier infection histories during a SARS-CoV-2 outbreak in Shanghai in spring 2022. Compared to an earlier patient cohort infected by SARS-CoV-2 prototype strains in 2020, BA.2.2 infection led to distinct fluctuations of pathophysiological markers in the peripheral blood. In particular, severe/critical cases of COVID-19 post BA.2.2 infection were associated with less pro-inflammatory macrophage activation and stronger interferon alpha response in the bronchoalveolar microenvironment. Importantly, the abnormal biomarkers were significantly subdued in individuals who had been immunized by 2 or 3 doses of SARS-CoV-2 prototype-inactivated vaccines, supporting the estimation of an overall 96.02% of protection rate against severe/critical disease in the 4854 cases in our BA.2.2 patient cohort with traceable vaccination records. Furthermore, even though age was a critical risk factor of the severity of COVID-19 post BA.2.2 infection, vaccination-elicited protection against severe/critical COVID-19 reached 90.15% in patients aged ≽ 60 years old. Together, our study delineates the pathophysiological features of Omicron BA.2.2 sublineages and demonstrates significant protection conferred by prior prototype-based inactivated vaccines.
Humans ; Aged ; Middle Aged ; COVID-19/prevention & control* ; SARS-CoV-2 ; Pandemics/prevention & control* ; China/epidemiology* ; Disease Outbreaks/prevention & control* ; Vaccination

Objective:To explore the intention of exclusive breastfeeding and its influencing factors within six months after delivery of pregnant women in the third trimester of pregnancy in Xi'an.Methods:From January to February 2019, convenience sampling was used to select 2 671 pregnant women in the third trimester of pregnancy who underwent regular obstetric examinations in Obstetrics Clinic of five hospitals in Xi'an for a cross-sectional survey. Pregnant women were surveyed by means of a field survey using a self-designed Exclusive Breastfeeding Intention of Pregnant Women in the Third Trimester Questionnaire. Multivariate Logistic regression was used to analyze the influencing factors of the intention of exclusive breastfeeding among pregnant women in the third trimester. A total of 2 671 questionnaires were distributed, 2 479 valid questionnaires were recovered, and the valid recovery rate was 92.8% (2 479/2 671) .Results:A total of 60.8% (1 507/2 479) of pregnant women planned to exclusively breastfeed within 6 months of delivery. Pregnant women in the third trimester of pregnancy whose husbands ( OR=2.950, 95% CI: 2.097-4.066) and family members ( OR=2.171, 95% CI: 1.571-3.000) supported exclusive breastfeeding had high intention to exclusively breastfeed, and those who participated in breastfeeding courses had a high intention to exclusively breastfeed ( OR=1.436, 95% CI: 1.199-1.719) . Conclusions:More than half of third-trimester women plan to exclusively breastfeed within six months postpartum. Husband and family support and enrolment in breastfeeding classes increase the intention of pregnant women to exclusively breastfeed. Prenatal breastfeeding courses should be carried out to raise the awareness of pregnant women and family members about exclusive breastfeeding, and focus on the support of husbands and family members for exclusive breastfeeding, so as to increase the exclusive breastfeeding rate within six months after delivery.

Objective:To explore a new training mode for nursing professionals suitable for the 1+X certificate system, and realize the training goal of "one specialty and multi-ability" compound technical nursing talents.Methods:To take the "1+ X" certificate standard as the basis for the construction of nursing specialty, to reconstruct the talent training program of integration of graduation certificate and certificate. To take the content of "1+X" certificate as the basis for the construction of professional courses, construct the core curriculum system of integration of curriculum and certificate. To build a "new double-qualified" teaching staff and constructing of new double-qualified teachers and accelerate the development of quality resources.Results:The talent training mode of integration of graduation certificate and certificate under the 1+X certificate system was constructed. The curriculum structure has been optimized. The teachers′ability of teaching, training and examination was improved.Conclusions:The new mode of training nursing professionals under the 1+X certificate system meets 1 degree education and X vocational training of nursing students and achieve a "1" and "X" seamless convergence. It provides innovative ideas for the promotion and implementation of 1+X certificate system pilot work in the field of nursing education nationwide.

Background: Nummular eczema (NE) is an inflammatory skin disease characterized by pruritic coin-shaped lesions and a long-lasting and easy-relapsing course, which severely decreases patients' qual-ity of life. This case was designed to observe the effects of specific acupuncture techniques on pruritic NE management.Case presentation: A 22-year-old female was first diagnosed with pruritic NE three years earlier. No al-lergies were found in the patch test;while emotional stress would trigger and aggravate the NE. External application of 0.1％tacrolimus failed to reverse this condition over a long period of treatment. Treatment&outcomes: An individualized acupuncture treatment protocol was identified. Half needling and encircling needling were applied at local eczematous lesions, with routine needling at meridian points, once per week, for 12 treatment sessions. All outcome measures, including the Eczema Area and Severity Index, Visual Analogue Scale score for pruritus, Self-Rating Anxiety Score, and Dermatology Quality Life Index, substantially improved over 6 months from pre-treatment to 3 months post-treatment. Conclusion: Acupuncture might be a promising non-pharmacological treatment method for patients with NE, especially for those with emotional stress. A randomized controlled trial with an adequate sample size and rigorous study design is required to verify the results of the study.

Objective To investigate the clinical efficacy of short segment fixation with percutaneous pedicle screws or traditional open surgery for the type A1-A3 thoracolumbar compression fracture.Methods A retrospective case control study was conducted on the clinical data of 64 patients with thoracolumbar compression fracture admitted to Shanxi Dayi Hospital between January 2012 and February 2017.There were 44 males and 20 females,aged 21-65 years [(45.4 ± 11.1) years].There was one patient with injured segment at T11,29 at T12,27 at L1 and seven at L2.According to AO typing,there were 39 patients classified as Type A1,two as Type A2 and 23 as Type A3.The patients were divided into minimally invasive surgery group (n =37) and open surgery group (n =27).Minimally invasive surgery group was treated with minimally invasive percutaneous pedicle screw fixation and open reduction.The open surgery group was treated with traditional open pedicle screw short segment fixation and open reduction.The operation time,intraoperative blood loss,total hospitalization time,postoperative hospitalization time,visual analogue scale (VAS) before and after operation,local kyphosis of the fractured vertebra,segmental kyphosis and complications in two groups were recorded.Results All patients were followed up for 12-29 months,with an average of 13.2 months.Between the minimally invasive surgery group and open surgery group,no significant difference was found in the operation time [(106.4± 37.3) minutes vs.(131.3 ± 33.6) minutes] (P ＞ 0.05),and significant differences were found in intraoperative blood loss [(71.2 ± 34.9) ml vs.(409.3 ± 267.5) ml],total hospitalization time [(11.7 ± 7.2) days vs.(21.6 ± 12.8) days] and postoperative hospitalization time [(8.1 ± 7.4) days vs.(16.6 ± 10.6) days] (P ＜ 0.05).In the minimally invasive surgery group,VAS was (6.5 ±1.1) points preoperatively and was (2.3 ± 0.7) points and (1.0 ± 0.3) points immediately after operation and at final follow-up.In the open surgery group,VAS was (6.9 ± 1.0)points preoperatively and was (4.2 ± 1.0) points and (0.9 ± 0.4) points immediately after operation and at final follow-up (P ＜0.05).Compared with the preoperative VAS,those immediately after operation and at final follow-up were significantly decreased within the two groups (P ＜ 0.05).There were no significant differences in the preoperative VAS and VAS at final follow-up between the two groups (P ＞ 0.05),but significant difference was found in VAS immediately after operation between the two groups (P ＜ 0.05).In the minimally invasive surgery group,the local kyphosis of the fractured vertebra was (19.3 ± 3.8) °preoperatively,(3.4 ± 1.7) ° immediately after operation,and (4.6 ± 1.9) ° at final follow-up.In the open surgery group,the local kyphosis of the fractured vertebra was (19.6 ± 6.8) ° before operation,(1.6 ± 0.8) ° immediately after operation,and (2.4 ± 1.1) ° at final follow-up.The kyphosis of fractured vertebra immediately after operation and at final follow-up were significantly decreased within the two groups compared with the preoperative kyphosis(P ＜0.05),but no significant differences were found between the two groups (P ＞ 0.05).In the minimally invasive surgery group,the segmental kyphosis Cobb angle was (16.1 ± 9.1) ° before operation,(3.0-± 1.8) ° immediately after operation,and (5.9 ±1.8) ° at final follow-up.In the open surgery group,the segmental kyphosis Cobb angle was (15.2±12.0) ° before operation,(3.1 ± 1.4) ° immediately after operation,and (5.6 ± 2.1) ° at final follow-up.The segmental kyphosis Cobb angle immediately after operation and at final follow-up were significantly decreased within the two groups compared with the preoperative Cobb angle (P ＜ 0.05),but no significant differences were found between the two groups (P ＞ 0.05).No spinal cord injuries because of pedicle screws were observed after operation in either group.In the open surgery group,there was one patient with wound infection who recovered after dressing change,and no infection case was found in the minimally invasive surgery group.Conclusion For type A1-A3 thoracolumbar compression fractures,both the minimally invasive posterior pedicle screw fixation and the traditional open pedicle screw fixation can achieve satisfactory near-term results,and the former is better in intraoperative blood loss,immediate relief of pain after operation and shorter hospital stay than the latter.

With the market-oriented application of new technologies and the development of various subjects in hospitals, more and more point-of-care test(POCT) devices appear in medical institutions, as an important method for rapid clinical acquisition of test results. As introduced by the authors, the hospital since 2017, established based on the hospital′s total quality management system, the POCT management committee, and built the hospital′s POCT quality management system. Thanks to its efforts, the hospital has fully standardized the POCT management from equipment procurement, test, maintenance, personnel training and examination, thus further ensuring medical quality.

Objective To explore the mechanism of SH?SY5Y mitochondrial dysfunction treated by manganese to find a new potential therapeutic target. Methods Transmission Electron Microscopy(TEM)to observe the morphology of mitochondria. Cell treated with 250μmol/L for periods of time(2 h, 4 h, 6 h)while mitochondrial membrane potential(MMP)and ROS can be detected by FCM and fluorescence microplate reader. Results After treating with MnCl2 in 6 h, TEM images showed early vacuoles, lamellar structures of SH?SY5Y cells. Then test the mitochondrial membrane potential and showed that MMP would be decreased gradually. Meanwhile, analysis showed that in comparison with control, treatment group had a higher ROS level respectively (P < 0.05). Conclusion MnCl2 can cause mitochondrial damage through a mechanism closely related to disrupt the MMP or generate abundant ROS.

Objective To investigate the effects of individualized medical nutrition therapy (IMNT) on the nutrition metabolism index and pregnancy outcome in gestational diabetic mellitus (GDM) patients during pregnancy and lactation periods. Methods Totally 98 female patients diagnosed with GDM from the Second Hospital of Hebei Medical University were selected from June 2014 to September 2015 and divided into the study group and the control group according to the principles of randomization. 51 patients in the study group received intervention of IMNT during pregnancy and lactation periods. 47 patients in the control group received traditional oral nutritional intervention model. The purpose was to observe the changes of biochemical indicators among different periods and pregnancy outcomes between two groups at the 3rd and 6th month after intervention. Results The metabolism index including fasting blood glucose ( FBG ) , postprandial blood glucose (PBG), HbA1c, Ca2+, CHOL, TG, TP, and ALB of the study group were significantly better than that of the control group ( P<0. 05 ) . The incidence rate of pregnancy-induced hypertension syndrome, polyhydramnios and other complications, and the Cesarean delivery rate was also significantly lower in the study group than those in the control group ( P<0.05) . Macrosomia, hypoglycemia, asphyxia, high blood bilirubin, fetal distress, premature birth rate, and the neonatal Apgar score ratio after postpartum in the study group were significantly better than the control group ( P<0.05) . The average weight gain among the pregnant women, the postpartum maternal weight, and the neonatal average birth weight of the study group were significantly lower than that of the control group (P<0.05). Conclusions IMNT can ensure good pregnancy outcome, and help to effectively control nutrition metabolic indices; It is a safe and important non-drug intervention to ensure the safety of mothers and their fetus.

Objective To explore the diagnostic consistency and correlation between MR discography (MRD) and CT discography (CTD) in diagnosing chronic low back pain. Methods Guided by C - arm fluoroscopy the mixed solution of gadoterate meglumine (GD-DOTA) and Iohexol (GD-DOTA at a dilution of 1 ∶ 400 with Iohexol) was injected into 96 lumbar intervertebral discs of the 36 patients. CT scanning was performed at 15 minutes after the injection of contrast, and axial together with sagittal SE T1WI MR scanning was carried out one hour after the injection. CTD and MRD images were randomly numbered and were independently evaluated by two experienced radiologists according to Dallas discogram scale in order to assess the diagnostic consistency and correlation between (MRD) and (CTD). In addition the diagnostic value of MRD was evaluated. Results The results revealed that in determining disc degeneration grade CTD and MRD were highly consistent with each other(Kappa = 0.836, P < 0.01), and the diagnostic results judged by the two reviewers were essentially in agreement (ICC = 1.00, P < 0.01; r = 0.997, P < 0.01). Higher consistency (Kappa = 0.836, P < 0.01) and correlation(ICC = 0.90, P < 0.01; r = 0.869, P < 0.01; Kappa =0.836, P < 0.01) in determining annulus rupture extent were also obtained. Conclusion MRD is an accurate diagnostic method for the determination of disc degeneration and the severity of annulus rupture, and this technique has greater consistency and correlation with CTD in diagnosing chronic low back pain.

OBJECTIVETo investigate the role of tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) in regulating both angiogenesis and the expressions of phosphatase and tensin homologue deleted on chromosome 10 (PTEN) and vascular endothelial growth factor (VEGF)/Flk-1 expression in human proximal tubular epithelial cells (HKC).

METHODSHKC cells were transfected with two recombinant plasmids containing sense and antisense full-length TIMP-1 cDNA (TIMP-1S-pcDNA3.0 and TIMP-1AS-pcDNA3.0, respectively) constructed previously, or treated with 100 µmol/L MMP-2/MMP-9 inhibitor III (with similar cellular enzyme suppression activity with sense TIMP-1 plasmid). The mRNA expression of TIMP-1, MMP-2, MMP-9, PTEN, VEGF and Flk-1 were examined by RT-PCR. In each group, the expression of PTEN, VEGF and Flk-1 were also detected using an indirect immunofluorescence assay.

RESULTSCompared with non-transfected cells and cells transfected with the empty vector, sense TIMP-1-transfected cells showed obviously upregulated PTEN expression (P<0.05) and significantly lowered gelatinase activity (P<0.05) and VEGF and Flk-1 expressions (P<0.05). Transfection with the antisense TIMP-1 plasmid produced the reverse results (P<0.05). MMP-2/MMP-9 inhibitor III did not obviously affected the expression of PTEN, VEGF or Flk-1 as compared with the non-transfected or empty vector-transfected cells.

CONCLUSIONIn the aging progress, the renal tissues express high levels of TIMP-1 to upregulate PTEN expression via a MMP-independent pathway, and subsequently down-regulates the expression of VEGF and Flk-1 to cause aging-related impairment of renal angiogenesis. These findings provide new evidence for understanding the role of TIMP-1 in renal aging.

Cells, Cultured ; Epithelial Cells ; metabolism ; Humans ; Kidney Tubules, Proximal ; cytology ; Matrix Metalloproteinase Inhibitors ; PTEN Phosphohydrolase ; metabolism ; RNA, Messenger ; genetics ; Tissue Inhibitor of Metalloproteinase-1 ; genetics ; metabolism ; Transfection ; Vascular Endothelial Growth Factor A ; metabolism ; Vascular Endothelial Growth Factor Receptor-2 ; metabolism